How to avoid purging from Accutane (isotretinoin) - Dermatologist and acne expert explains

[@faisalahmad5945]

Wonderful video Dr. Barbieri! I'm a dermatology resident and your videos and papers have definitely had a significant influence on the way I treat acne!

[@DrJohnBarbieri]

Glad it was helpful!

[@DrJohnBarbieri]

Glad it was helpful!

[@lucianonandino4569]

Could you do a video on some of the current acne scar procedures and their effectiveness? i.e. subcison, TCA cross, and the various lazers?

[@DrJohnBarbieri]

That would be a great topic for a future video. There is very little high-quality evidence on the topic, which makes it challenging to cover other than describing how the treatments work (i.e. we don't really know which is best, etc).

[@africanqueenv]

Can you use antihistamines to stop purging with topical retinoids?

[@DrJohnBarbieri]

No one has done that study, but I would expect that they might be helpful in that setting as well.

[@utsavdey7161]

Hello Doc, can accutane 5mg be taken as maintenance dose daily indefinitely?

[@DrJohnBarbieri]

Sometimes low dose or intermittent dosing regimens (e.g. MWF) are used to maintain long-term clearance in those who are prone to recurrence.

[@utsavdey7161]

​Thanks for the reply.....can you please confirm if it a safe option ?​@@DrJohnBarbieri

[@lambriefmejico9702]

im on 20mg for almost 2months now i take fish oil and antihistamine along with it and fatty food whenever i take the accutane at first it was ok but now im getting too much close comedones and large CYSTIC acne painful idk understand and i dont feel any side effect my lips are good skin no dryness so im not sure if this is purging or my body doesnt want it help pls thanks

[@DrJohnBarbieri]

I cannot speak to your specific situation or provide you with medical advice, and would recommend you discuss with your doctor. This article can be a helpful summary of what to expect in terms of average improvement by month: www.ncbi.nlm.nih.gov/pmc/articles/PMC7344833/

[@Macorelppa]

Let it purge if remission is your goal.

[@DrJohnBarbieri]

I think it's possible to achieve long-term remission without severe purging. The best predictors of long-term remission are higher cumulative dose and having clear skin for a few months before stopping.